30 with vasovagal, heart had 7 1/2 second pause

[mcalderon91723]

I was just diagnosed with vasovagal syndrome because I passed out wearing an event monitor and it showed my heart slowing down, then have a 7 1/2 second, and 2 1/2 second pause.  Is this normal with vasovagal?  Everything I read relates this condition to things such as standing to fast, or fainting from seeing blood, etc.  I can't seem to wrap my mind around these two conditions being the same.  My echo showed my heart is healthy and all my labs are normal.  My treatment plan is to avoid triggers, and if that is not working and I keep passing out we will explore the possibility of a pacemaker.  I'm scared and feel confused.  I'm only 30 and I have a daughter. I don't want to die.    

[itdood]

Hi  mcalderon91723,

If this were me, one of the things I'd like to know would be what terminated the 7.5 second pause?

My understadning is that every cell in your heart can become a pacemaker.  It's nature's wonderful backup system in case the regular pacemaker signal doesn't reach the ventricles.  The noraml pacemaker is a group of cells in the atrium called the "sino atrial node"  or SA node.  

For some reason, during that pause, the SA signal either didn't fire or it didn't reach the ventricle.  

Once of two things happened.  Either the SA node failed to fire or it did fire but the signal didn't reach the ventricles for some reason.   I'd want to know which of these occured.

Also I'd like to know what got the ventricles going again.  My understanding is that the pacemaker cells in the Ventricles can take over in the event it doesn't receive a signal to beat.  this is called an "escape beat".  On you holter they should be able to tell if the ventricles fired an escape beat or if the next beat was something called "normal sinus rhythm" or NSR.  usually the ventricles will fire an escape beat within 3-4 seconds of not getting NSR.  There are 2 types of escape beats.

So here are some terms for you to google and research and learn for yourself

escape beat
normal sinus rhythm
heart pause


If it were me I'd be trying to zero on two things at this point with your doctors

What caused the pause:  missing NSR?  Block?
What terminated the pause:  Escape beat?  what kind of escape beat?  NSR?

[Mom2four85]

What were you doing when you fainted? make sure you keep track of your symptoms from now on it will be very helpful to you in the future - what are your triggers you're supposed to avoid? Did they recommend to keep hydrated and out of the heat?  If they've recommended a pacemaker, I would assume you have bradycardia and your heart rate is low?

Did your doctor recommend a HuTT? It's head up tilt table test or Tilt test to find out WHY you fainted? so many doctors overlook this test and will not order one - why I have no clue but I went from age 9 to 42 until my EP said hey we need to find out why you're fainting :P  google it and you'll find alot of info

If what is wrong with you is neurologically related, it could be anything in the "dysautonmia" realm - Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope NCS, mitral valve prolapse dysautonomiaMVPD, pure autonomic failure OI, autonomic instability and others - most doctors are confused about this and patients like me go years without proper diagnosis or treatment.

I think you're getting it a bit confused - there is vasovagal syndrome w/ fainting such as seeing blood; going to the bathroom etc, but there's also what I listed above with neurological problems involved -  the HuTT can rule out it being Neurological or Heart related

If you find out it isn't just a vasovagal response, we do have a Dysautonomia forum here under related communities that you may find helpful.

[Jerry_NJ]

The good results from the echo is a good start to build optimism...   The slow, or stop/start cycle is a concern both for passing out worse.  

I assume your normal heart rate is fine and regular and your blood pressure is also good.  Avoiding triggers is problematic if you don't know what the triggers are... do you have anything you can associate with the passing out episodes?  

You doctor(s) is your best answer and all I can think of is if they believe you can work for improvement, rather than go for a pace maker at this point, they must believe you are not at an immediate risk of heart failure.  

If you do a search on this community (forum) for pacemaker I'm sure you,ll find some insights into living with one and also that young people sometimes need that device.  I get a bit mixed up, it may be if your normal HR is fast enough you can be protected with an aimplantable cardioverter defibrillator (ICD) - to my understanding those are fire only if here is a heart stop.... which would likely be set to include a 2 second pause.

I am just going from memory, I do not have any personal experience.  I hope you get more helpful input for others who have a similar experience, and have lived on to beat it.